Healthcare Provider Details

I. General information

NPI: 1518351287
Provider Name (Legal Business Name): COLUMBUS CARDIOLOGY CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2015
Last Update Date: 05/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

745 W STATE ST SUITE 610
COLUMBUS OH
43222-1515
US

IV. Provider business mailing address

745 W STATE ST SUITE 610
COLUMBUS OH
43222-1515
US

V. Phone/Fax

Practice location:
  • Phone: 614-224-0093
  • Fax: 614-221-5480
Mailing address:
  • Phone: 614-224-0093
  • Fax: 614-221-5480

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number35048330M
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number35048330M
License Number StateOH

VIII. Authorized Official

Name: DR. MICHAEL R. MURNANE
Title or Position: PRESIDENT
Credential: M.D.
Phone: 614-224-0093